Cryo‐Immunoelectron Microscopy of Adherent Cells Improved by the Use of Electrospun Cell Culture Substrates

Electrospun nanofibres are an excellent cell culture substrate, enabling the fast and non‐disruptive harvest and transfer of adherent cells for microscopical and biochemical analyses. Metabolic activity and cellular structures are maintained during the only half a minute‐long harvest and transfer process. We show here that such samples can be optimally processed by means of cryofixation combined either with freeze‐substitution, sample rehydration and cryosection‐immunolabelling or with freeze‐fracture replica‐immunolabelling. Moreover, electrospun fibre substrates are equally suitable for complementary approaches, such as biochemistry, fluorescence microscopy and cytochemistry.     

应用坚固内固定技术治疗颌骨骨折的效果分析

目的：探究坚固内固定技术对颌骨骨折的治疗运用,为颌骨骨折的治疗方法选择提供理论指导。方法：选取我科自2009年4月-2012年7月收治的80例下颌骨骨折患者行手术切开复位、小型和微型钛板坚固内固定术治疗,纳入内固定组,并选取同期80例行颌间固定的颌骨骨折患者,纳入颌间固定组,对比两组患者治疗效果。结果：两组患者术后3个月张口度及张口型均得到明显改善,内固定组改善程度较颌间固定组更为显著（P〈0．05）;内固定组治疗周数、口臭及咬合错乱发生率均低于颌间固定组（P〈0．05）;内固定组疗效评价优43例,良26例,有效率86．3％,颌间固定组分别为31例和17例,有效率60．0％,内固定组治疗效果显著优于颌间固定组（P〈0．05）。结论：坚固内固定技术具有组织相容性高、口功能恢复快、不良反应发生率低等优势,是治疗颌骨骨折的安全、可靠、简便的治疗方案,能够有效保证患者的预后和生活质量,值得临床普遍应用。     

Skeletal Manifestations of Hydatid Disease in Serbia: Demographic Distribution,Site Involvement,Radiological Findings,and Complications

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9±18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn''t develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.     

开放性骨折患者发生医院感染的临床特征及危险因素分析

目的:研究开放性骨折患者发生医院感染的临床特征及危险因素,为降低院内感染提供临床参考。方法:回顾性分析于2013年3月-2015年3月间院内收治的1860例开放性骨折患者临床资料,对存在院内感染患者的感染类型、病原菌类型及相关危险因素进行分析,应用SPSS19.0统计软件对数据进行研究。结果:1860例患者中共计65例出现医院感染情况,发生率为3.49%,感染类型主要为骨髓炎占35.38%,肺部感染伴血气胸占23.08%,颌面部创伤后发生颅内感染占18.46%;65株病原菌中包括38株革兰氏阴性菌,占58.46%,23株革兰氏阳性菌,占35.38%,4株真菌,占6.15%;病程、骨折部位、损伤程度及住院时间为开放性骨折医院感染的独立危险因素,差异具有统计学意义(P0.05)。结论:通过分析开放性骨折患者医院感染的临床特征及危险因素,有利于医院防治工作的开展,为医院感染防治提供理论支持,具有重要指导意义。     

螺旋CT扫描及三维重建技术在股骨颈骨折分型及治疗中的应用

目的:探讨螺旋CT扫描及三维重建技术在股骨颈骨折分型及治疗中的应用价值。方法:选择2010年5月~2013年5月期间我院收治的股骨颈骨折患者237例为研究对象,根据患者扫描检查方式的不同将其分为对照组(112例)和观察组(125例),对照组患者行髋关节X线正位扫描,观察组行髋关节正位64排螺旋CT扫描,两组均根据扫描结果进行分型并制定相应的治疗方案,比较两组患者骨折内固定手术后2年的股骨头坏死率及骨折不愈合率。结果:两组行骨折内固定手术比例比较,差异无统计学意义(P0.05);术后2年,对照组股骨头坏死5例(22.73%),骨不连6例(27.27%);观察组股骨头坏死1例(3.70%),骨不连1例(3.70%),观察组患者股骨头坏死率及骨折不愈合率均显著低于对照组,差异均有统计学意义(P0.05)。结论:螺旋CT扫描及三维重建成像能够全面、准确显示股骨颈骨折的损伤情况,有助于骨折的正确分型和治疗方法的选择,改善预后。     

不同方法修复Pilon骨折的临床疗效比较

目的:比较不同方法修复Pilon骨折的临床疗效。方法:选取我院收治的Pilon骨折患者156例为研究对象,根据手术方法不同,将患者分成研究组和对照组,每组78例。研究组给予分步延期切开复位内固定手术治疗,对照组给予有限内固定结合外固定的手术治疗。观察并比较两组患者的踝关节功能、术中出血量、骨折愈合时间、住院时间以及术后不良反应的发生情况等。结果:与术前比较,两组患者术后踝关节功能均获得改善,且研究组踝关节功能优秀率高于对照组,差异具有统计学意义(P0.05);研究组患者术中出血量、骨折愈合时间、住院时间均明显低于对照组,差异具有统计学意义(P0.05);研究组不良反应发生率低于对照组,差异具有统计学意义(P0.05)。结论:分步延期切开复位内固定手术治疗pilon骨折的临床效果显著,是临床治疗pilon骨折的理想方案。但在临床实践中,应根据患者病情选择合适的治疗方案。     

椎弓根钉棒系统加植骨融合治疗胸腰椎爆裂性骨折并脊髓损伤的 临床研究

目的:探讨椎弓根钉棒系统加植骨融合治疗胸腰椎爆裂性骨折并脊髓损伤的疗效。方法:回顾性分析2010年3月至2014年12月,采用椎弓根钉棒系统加植骨融合治疗93例胸腰椎爆裂性骨折并脊髓损伤患者的资料,男56例,女37例。致伤原因:交通事故伤27例,高处坠落伤47例,重物压伤19例。骨折节段:L1骨折22例,L2骨折16例,L3骨折6例,T11骨折15例,T12骨折34例。结果:本研究共93例患者,所有患者经过一般12个月的随访,其中平均随访13.8月(10-16月)。与术前相比,患者术后6个月伤椎前缘高度比值明显增加,Cobb角值和椎管占位率明显降低(t=6.167,7.241,7.143,P0.05)。术后12个月伤椎前缘高度比值明显增加,Cobb角值和椎管占位率明显降低(t=9.345,11.541,11.263,P0.05)。且患者术后12个月与术后6个月在伤椎前缘高度比值、Cobb角、椎管占位率上比较,差异具有统计学意义(t=9.632,8.154,7.415,P0.05),根据Frankel神经分级,术后大部分患者神经功能有所恢复。其中,Frankel分级为A的患者有35例恢复,术后有效恢复率为87.5%;B级患者有25例恢复,术后有效恢复率89.3%。C级和D级患者术后有效恢复率均为100%,B,C,D级患者与A级患者有效恢复率相比,差异没有统计学意义(x~2=0.051,2.196,1.253,P0.05),随访12个月期间,2例患者术后5个月出现内固定物松动,1例术后12个月发生螺钉断裂,其余患者无伤口感染、肺部感染、深静脉血栓等并发症发生。结论:椎弓根钉棒系统加植骨融合能有效治疗胸腰椎爆裂性骨折并脊髓神经损伤,术后患者神经功能恢复较好,并发症较少,值得临床推广使用。     

抗感染活性骨治疗感染性胫骨骨不连的临床研究

目的:观察抗感染活性骨(ARBX)治疗感染性胫骨骨不连的临床效果。方法:回顾性分析我院自2008年1月-2015年1月收治并系统随访应用抗感染骨治疗的36例创伤后感染性骨不连病例,给予原内固定取出或外架拆除,病灶清除,去除硬化骨及死骨,髓腔再通,抗感染活性骨植骨,外架或钢板重新固定,统计患者病程时间,伤口愈合时间,患者院前手术次数,滴注引流时间及抗生素应用疗程,骨性愈合时间,内、外固定物拆除时间以及功能恢复情况,并总结治疗疗效。结果:平均随访2.4年(1年2月-4年10月),骨不连彻底治愈30例,4例患者感染控制,半皮质愈合,2例感染复发,骨不连未愈合。结论:1抗感染活性骨是治疗感染性骨不连的一种有效的植骨材料,具有控制感染,促进骨折愈合的作用;2彻底清除坏死,失活组织是控制感染,促进感染性骨不连愈合的关键;3清理断端,断端骨髓腔再通可促进成骨,促进骨折愈合。     

Zoogeography of the San Andreas Fault system: Great Pacific Fracture Zones correspond with spatially concordant phylogeographic boundaries in western North America

The purpose of this article is to provide an ultimate tectonic explanation for several well‐studied zoogeographic boundaries along the west coast of North America, specifically, along the boundary of the North American and Pacific plates (the San Andreas Fault system). By reviewing 177 references from the plate tectonics and zoogeography literature, I demonstrate that four Great Pacific Fracture Zones (GPFZs) in the Pacific plate correspond with distributional limits and spatially concordant phylogeographic breaks for a wide variety of marine and terrestrial animals, including invertebrates, fish, amphibians, reptiles, birds, and mammals. These boundaries are: (1) Cape Mendocino and the North Coast Divide, (2) Point Conception and the Transverse Ranges, (3) Punta Eugenia and the Vizcaíno Desert, and (4) Cabo Corrientes and the Sierra Transvolcanica. However, discussion of the GPFZs is mostly absent from the zoogeography and phylogeography literature likely due to a disconnect between biologists and geologists. I argue that the four zoogeographic boundaries reviewed here ultimately originated via the same geological process (triple junction evolution). Finally, I suggest how a comparative phylogeographic approach can be used to test the hypothesis presented here.     

骨质疏松骨折与非骨质疏松骨折治疗比较

目的:对比骨质疏松骨折与非骨质疏松骨折的临床特点和治疗方式,为骨折的临床诊治提供依据。方法:选取2010年12月至2013年12月在我院接受治疗的骨折患者186例。根据骨质疏松情况,将所选患者分为骨质疏松骨折组和非骨质疏松骨折组,每组各93例。分析并比较两组患者的治病原因、治疗方法以及临床效果。结果:非骨质疏松骨折组患者交通事故和砸伤致伤率均显著高于骨质疏松骨折组,而跌倒伤致伤率低于骨质疏松骨折组,差异具有统计学意义(P0.05);两组患者手术治疗方式差异无统计学意义(P0.05);骨质疏松骨折组患者保守治疗的临床疗效优于非骨质疏松骨折组,差异具有统计学意义(P0.05);两组手术治疗的临床疗效比较,差异无统计学意义(P0.05)。结论:在临床治疗的实践中,应根据患者骨质疏松病情实施针对性的治疗,从而提升治疗的针对性和有效性。